Doctor Name: | SANGILI CHANDRAN |
NPI Number: | 1790705663 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 4140 Southwest Hwy Hometown, IL - 604561135 |
Business Phone Number: | 7084225700 |
Business Fax Number: | 7084228225 |
Mailing Address: | 4140 Southwest Hwy, HOMETOWN |
State: | IL |
Postal Code: | 604561135 |
Phone Number: | 7084225700 |
Fax Number: | 7084228225 |
NPI Enumeration Date: | 07/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204C00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
Taxonomy Specialization: | |
Taxonomy Definition: |